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June 2020

In June 2020 we received 15 FOI requests. On this page you can find a full list of the requests we received, along with our response.
Clinical management

FOI 81010 Radiology services. Date requested 2 June 2020

Request received

I would be grateful if you answer these questions on radiology services provided by your CCG.

  1. How many scans have you commissioned for ultrasound scans, MRI scans and CT scans over the last 3 years, and to which providers?
  2. Please list details of the contracts you currently have for radiology services, including:
    • Providers name
    • Contract start date, length and expiry date
    • Contract value
  3. Whether the contract will be re-tendered at expiry or if a renewal with the same provider is expected

Our response: 19 June 2020

Email our FOI team for a copy of the completed spreadsheet.

Continuing healthcare

FOI 81020 information. Date requested 3 June 2020

Request received

  1. How many full assessments (MDT or DST meeting) were carried out by your CCG in each of the last 5 financial years?
  2. How many local review meetings took place in each of the last 5 financial years?
  3. How many cases were granted full NHS continuing healthcare funding (eligible decisions):
    • in each of the last 5 financial years?
    • following the MDT or DST meeting in each of the last 5 financial years?
    • following their local review meeting (following an ineligible decision after an MDT/DST meeting) in each of the last 5 financial years?
  4. What is the total population covered by your CCG and what number are over 65 years?

Please do not include any information regarding fast track applications or NHS funded nursing care applications. Please do not include in your responses any funding decisions relating to either of these. I am only interested in applications that have passed the initial checklist assessment and have proceeded to a full assessment.

Our response: 12 June 2020

For questions 1, 3 and 4:

Year Eligible Not eligible Total
2015/2016 143 248 391
2016/2017 139 318 457
2017/2018 161 405 566
2018/2019 197 561 758
2019/2020 66 492 558

For question 2 and 5:

Question 2015/2016 2016/2017 2017/2018 2018/2019 2019/2020
2 19 26 16 17 21
2016/2017 Less than 5 9 Less than 5 Less than 5 6

NHS Kernow holds the information but where the numbers are less than 5. The information cannot be disclosed as it could potentially identify the individuals involved. Especially if combined with other data, this would constitute a breach of the Data Protection Act 2018. Therefore, this information is exempt from disclosure under section 40(2) of the Freedom of Information Act 2000 on the grounds that it is personal information.

For question 6, at 1 April 2020, total population is 585,716 of which 143,552 are over 65.

Contracts

FOI 81260 Telephone and internet services. Date requested 24 June 2020

Request received

  1. Please confirm the manufacturer of your telephony system(s) that are currently in place?
  2. When was the installation date of your telephony equipment?
  3. Who maintains your telephony system(s)?
  4. Please confirm value of the initial project and value of annual support or maintenance services (in £)?
  5. Does your annual maintenance service include moves, adds and changes? And if not what is the annual cost of moves, adds and changes?
  6. When is your contract renewal date?
  7. Do you use unified communications or collaboration tools such as Microsoft Skype for Business, Teams, Cisco, Avaya or Mitel? If yes, what tools are you currently using?
  8. Please confirm the manufacturer of your contact centre system(s) that are currently in place?
  9. When was the installation date of your contact centre infrastructure?
  10. Who maintains your contact centre system(s)?
  11. Please confirm value of the initial project and value of annual support/maintenance services (in £)?
  12. How many contact centre employees or agents do you have?
  13. Do agents work from home? Or just your offices?
  14. When is your contract renewal date?
  15. Do you use a CRM in the contact centre? What platform is used?
  16. Do you use a knowledge base or management platform? What platform is used?
  17. Who currently provides your calls and lines?
  18. What is your current annual spend on calls and lines?
  19. When is your contract renewal date?
  20. Who provides your wide area network? How many sites are connected?
  21. How many employees do you have overall within your organisation?
  22. Can you provide contact details for your procurement lead or category manager for these services?
  23. Can you provide names and contact details for the following people within your organisation?
    • chief information officer or IT director
    • IT head
    • digital transformation head
    • customer services head

Our response: 17 July 2020

  • CISCO
  • 2008
  • Cornwall IT services
  • NHS Kernow was formed on 1 April 2013 so is unable to provide the installation cost. The annual support/maintenance is part of the block contract with Cornwall IT services.
  • Paid for ad-hoc
  • Part of ongoing SLA so not contracted individually.
  • Microsoft Teams
  • NEC
  • Unknown as prior to incorporation of NHS Kernow
  • Unify
  • NHS Kernow was formed on 1 April 2013 so is unable to provide the installation cost. The annual support/maintenance is part of the block contract with Cornwall IT services.
  • Headcount 29
  • Offices
  • In the process of migrating to a new system so will be May 2023
  • No.
  • No.
  • BT.
  • RMS line rental and call costs for 2019/2020 were £6,247. NHS Kernow line rental and call costs are included within the service charges paid to NHS Property Services and Community Health Partnership. Except for Peninsula House which was approximately £1,027.
  • Just in the process of migrating to a new system so will be May 2023
  • Cornwall IT services, It connects all 5 of our sites but many more on a Cornwall wide COIN
  • Staffing information is published in our annual report

For question 22 to 23, NHS Kernow does not release the names of employees below director level. Andrew Abbott, director for integrated care (primary care) is responsibility for IT and telephony.

FOI 81030 Dermatology services. Date requested 4 June 2020

Request received

Under the Freedom of Information Act 2000 I am seeking the following information:

  1. Which organisation(s) currently provide a community dermatology service to the CCG?
  2. What type of service is this, for example lead provider or AQP?
  3. On what date does this contract expire?
  4. Is there an optional contract extension in place for this community dermatology service? If so, for how long?
  5. Does the CCG have current plans to go out to tender for a new community dermatology service and if so, when?
  6. What is the current annual value of the CCGs current community dermatology service?
  7. Have any of the CCGs current community dermatology providers been issued with a performance notice during the lifetime of the contact and/or the last 12-months?

Our response – 23 June 2020

  1. NHS Kernow commissions 1 community dermatology service provider to patients registered with the 9 GP practices in east Cornwall. This contract is held by Kernow Health Community Interest Company. The remaining dermatology provision is provided via acute hospital contracts. The majority of this activity undertaken by Royal Cornwall Hospitals NHS Trust and University Hospitals Plymouth NHS Trust.
  2. This is a GP with an extended role contract, but aspects of service are supported by visiting consultants from University Hospitals Plymouth.
  3. 30 June 2020
  4. The community dermatology contract does not contain a contract extension option. However, the contract will be varied to run throughout 2020 to 2021 due to COVID-19.
  5. COVID-19 has delayed any about future contracting arrangements for this service.
  6. The contract value for Kernow Health CIC dermatology for the 2019 to 2020 financial year was £399,652
  7. No

FOI 81110 Dermatology services. Date requested 11 June 2020

Request received

  1. Is your community dermatology service provided as a separate contract or is it integrated into the secondary care service?
  2. Who is the current provider of the community dermatology service?
  3. Is the contract delivered in partnership with other providers? If so, who are the providers and from what sector (third sector, contractors)
  4. What is the contract length and contract value of the current community dermatology contract?
  5. Does the current service utilise artificial intelligence (AI)? If yes, which parts of the pathway is the AI used in? What are the success rates for AI compared to consultants in the service? If no, would the CCG consider commissioning AI as part of a future service?
  6. Would it be possible to get a copy of the current service specification?
  7. When is the current community dermatology service due to be re-tendered?
  8. Is this date before contract extension (if so what is the extension period and likelihood of extension)?
  9. Is it anticipated the re-tendered service will adhere to the same model and specification as the current community dermatology service? If not, how do you expect this service to differ? Will you be undertaking market engagement ahead of any procurement process to inform this model? If yes, do you anticipate the contract length and financial envelope to remain the same or efficiency savings to be applied? What percentage reduction would this be?
  10. Has the current community dermatology service met all of the contracted KPIs during the lifetime of the contract?
  11. Has the current provider of the community dermatology service been served with any performance notices? If yes, when were they served and what for?
  12. Are there any areas of particular concern within the CCGs population which the community dermatology service could be addressing more effectively?
  13. Are there any areas of exceptional practice and/or innovation in the current community dermatology service which stand out to the CCG?
  14. What is the current patient satisfaction rate for the community dermatology service? Has this remained consistent or has there been fluctuations (reduced or improved)?
  15. Which virtual or remote platforms are used in the current community dermatology service? Telephone, Video general (WhatsApp, Skype, Zoom), Video bespoke (Q-Doc, Attend Anywhere)
  16. Has the community dermatology service continued to operate routine appointments during the COVID-19 pandemic via remote methods alongside emergency and urgent referrals?

Our response – 2 July 2020

  1. NHS Kernow has 1 separate contract for community dermatology services for patients registered with the 9 practices in east Cornwall.
  2. This contract is held by Kernow Health Community Interest Company. The remaining dermatology provision is provided via acute hospital contracts with the majority of this activity undertaken by Royal Cornwall Hospital Trust and University Hospital Plymouth Trust.
  3. Kernow Health Community Interest Company dermatology is delivered via 2 subcontractors. Dr Grant Stevens, GP with extended roles and The Rame Group Practice (Penntorr), GPs with extended roles. This is supported by visiting consultants from University Hospital Plymouth Trust.
  4. The contract length is 12 months and is due to expire on 30 June 2020. The contract value for Kernow Health Community Interest Company dermatology for the 2019/2020 financial year was £399,652
  5. The service does not currently utilise Artificial Intelligence. NHS Kernow would consider commissioning AI as part of a future service provided if there was robust evidence to support that it contributed to our commissioning strategy principles. For example delivered improved patient outcomes
  6. An attachment was returned for this response. Email our FOI team for a copy of this response.
  7. COVID-19 has delayed discussions about future contracting arrangements for this service.
  8. The community dermatology contract does not contain a contract extension option. The contract will be varied to run throughout 2020/2021 due to COVID-19.
  9. NHS Kernow is not in the position to discuss future contracting arrangement for this service other than that outlined above. This is due to COVID-19. Any variations to contract will also bring the contract in line with 2020 to 2021 NHS standard contracting terms and conditions.
  10. Yes
  11. None issued
  12. Nationally dermatology is a challenging area to address. The NHS Kernow area is no exception to this. We consider relevant guidance such as the elective care best handbooks which includes details of community dermatology models when reviewing how best to meet the needs of the CCGs population.
  13. None identified
  14. Complaints, never events and incidents have been reported as 0 for the last 11 months of this reporting period (month 12 data not yet available).
  15. Telephone and bespoke video conferencing via AccuRx.
  16. NHS Kernow took the decision following national guidance to suspend all routine referrals and appointments for 3 months effective 23 March 2020. We are now working with all our providers to restore routine activity where this does not adversely affect our overall system capacity to respond to COVID-19

FOI 81090 MSK services. Date requested 9 June 2020

Request received

  1. Is the current community MSK service based on a block contract or AQP model? If block contract who is the current provider of the service? If AQP how many providers are on the framework?
  2. Is the contract delivered in partnership with other providers? If so, who are the providers and from what sector (for example third sector, contractors)
  3. What is the contract length and contract value of the current community MSK contract?
  4. What is the treatment model for the current community MSK service? For example does the service include an MSK triage service that directs referrals to secondary care/specialist services as well as the community service? Does the community MSK service include an integrated pain management service?
  5. Would it be possible to get a copy of the current service specification?
  6. When is the current community MSK service due to be re-tendered?
  7. Is this date before contract extension (if so, what is the extension period and likelihood of extension)?
  8. Is it anticipated the re-tendered service will adhere to the same model and specification as the current community MSK service? If not, how do you expect this service to differ? 
  9. Will you be undertaking market engagement ahead of any procurement process to inform this model? If yes, do you anticipate the contract length and financial envelope to remain the same or efficiency savings to be applied? What percentage reduction would this be?
  10. Has the current community MSK service met all the contracted KPIs during the lifetime of the contract?
  11. Has the current provider of the community MSK service been served with any performance notices? If yes, when were they served and what for?
  12. Are there any areas of particular concern/health outcomes within the CCGs population which the community MSK service could be addressing more effectively?
  13. Are there any areas of exceptional practice and/or innovation in the current community MSK service which stand out to the CCG?
  14. What is the current Patient Satisfaction Rate for the community MSK service? Has this remained consistent or has there been fluctuations (reduced or improved)?
  15. Which virtual/remote platforms are used in the current community MSK service? Telephone, video general (WhatsApp, Skype, Zoom), video bespoke (Physitrack, Q-Doc)
  16. Has the Community MSK Service continued to operate routine appointments during the COVID-19 pandemic via remote methods alongside Emergency/Urgent referrals?

Our response – 30 June 2020

  1. Both. Community MSK is delivered by a number of providers via block and payment by results contract models. Cornwall Partnership NHS Foundation Trust and Royal Cornwall Hospitals NHS Trust. There are 14 AQP providers.
  2. No
  3. See table below.
  4. Triage of MSK referrals takes place via the Referral Management Service and Devon Referrals Support Service and via the MSK Interface service.
  5. Yes. Please note the AQP and non AQP specs are due for review, but this has been delayed due to COVID-19. Specifications were attached to the response. Email our FOI team for a copy.
  6. NHS Kernow has no current plans to re-tender community MSK services.
  7. Not applicable.
  8. Not applicable.
  9. No, some waiting time targets not achieved.
  10. No.
  11. Increased orthopaedic waiting times due to reduced capacity following response to COVID-19.
  12. Introduction of electronic outcome measures, piloting self-management programme (escape pain), co-ordinating local rollout of MSK first contact practitioners.
  13. Information not submitted consistently and historically by all providers so it is not possible to provide an overall rate or history of any changes in rates.
  14. Various across the different providers.
  15. As part of national directives on responding to COVID-19 pandemic, NHS Kernow suspended routine GP referrals and planned routine activity from Monday 23 March to allow system
    prioritisation of COVID, cancer and other urgent patients within restricted capacity. Conversations with MSK community providers regarding restoration of routine appointments began on 4 May and most have now resumed routine appointments, using remote methods as first line of contact.
Current provider Contract start date Contract length Potential contract extensions
Ascenti MSK AQP (lower back and neck) 01/04/2019 12 months 12 months
Cathedral Chiropractic MSK AQP (lower back and neck) 01/04/2019 12 months 12 months
Corbett AQP MSK (lower back and neck) 01/04/2019 12 months 12 months
Cornwall Partnership Foundation Trust MSK AQP (Lower Back and Neck), MSK Non AQP and MSK Interface 01/04/2018 3 years 3 years
Falmouth Health Centre – MSK AQP (Lower back and neck) 01/04/2019 12 months 12 months
Judith Handley – MSK AQP (Lower back and neck) 01/04/2019 12 months 12 months
Judith Handley Physiotherapy Services 01/04/2019 12 months 12 months
Lander Medical Practice – MSK AQP (Lower back and neck) 01/04/2019 12 months 12 months
Lander Medical Practice – Physiotherapy Services 01/04/2019 12 months 12 months
North Cornwall Physiotherapy MSK AQP (Lower back and neck) 01/04/2019 12 months 12 months
Plymouth Chiropractic Clinic Ltd (AQP) 01/04/2019 12 months 12 months
Royal Cornwall Hospital MSK AQP (Lower back and neck) and MSK Non AQP 01/04/2018 3 years
Sandy Hill MSK AQP (Lower back and neck) 01/04/2019 12 months 12 months
Sandy Hill Physiotherapy Services 01/04/2019 12 months 12 months
South Devon Osteopaths MSK AQP (Lower back and neck) 01/04/2019 12 months 12 months
Three Spires Medical – MSK AQP (Lower back and neck) 01/04/2019 12 months 12 months
Three Spires Medical Practice – Physiotherapy Services 01/04/2019 12 months 12 months
Three Spires Medical Practice – MSK Interface 01/04/2019 12 months 12 months
University Hospitals Plymouth NHS Trust MSK Non AQP 01/04/2019 12 months 12 months
Walsingham Clinic MSK AQP (Lower back and neck) 01/04/2019 12 months 12 months
COVID-19

FOI 81080 primary care. Date requested 9 June 2020

Request received

We are aware that different systems are being used across England to treat patients with COVID symptoms and those with non-COVID symptoms separately, where face to face consultations are required. Our aim is to rapidly update our review to include the use of hot hubs (and cold hubs where applicable) and request that you answer the following questions in relation to the NHS Kernow.

  1. Are hot and cold hubs being used to deliver face to face primary care to patients with suspected and actual COVID-19 symptoms and non COVID-19 symptoms respectively? If so, please could you indicate the numbers of each if possible.
  2. Are hot and cold sites (or red and green sites co-located within primary care settings) being used to deliver face to face primary care to patients with suspected/ actual COVID-19 symptoms and non COVID-19 symptoms respectively?
  3. Is a different model to question 1 above (including home visits, or other models) being used? If so, please describe this.
  4. Are each of the models used in question 1 available to the entire population? Or only in certain locations or populations? Please specify any such distinctions, for example those shielding or frail elderly populations.
  5. Immediately prior to any changes in service delivery related to COVID-19, was the hub model being used to deliver primary care?
  6. If so, how many hubs, where, and did these have specialist functions or were they accessible by all patients at practices which fed into them?
  7. If a hub model was not being used to deliver primary care immediately prior to any changes in service delivery with respect to COVID-19, had you previously used a hub model but stopped?
  8. If so, why was the decision made to stop using this model?
  9. Are you planning to evaluate your COVID-19 model(s) for face to face primary care consultations? Please provide any interim data concerning this for potential inclusion in our review. Please also provide any other relevant documentation regarding face to face primary care service delivery during the COVID-19 pandemic which could be helpful to our study.

Our response – 12 June 2020

  1. NHS Kernow’s 59 GP practices have been discussing how best to deliver safe care to their patients and the separation of hot and cold areas was established in the very early days of the COVID-19 pandemic. Through the implementation of telephone triage, on-line and video consultations the need for face-to-face appointments has greatly reduced but where a face-to-face appointment is required, those with COVID-19 symptoms are seen in hot hubs or hot areas within general practice. For most practices, zoned areas are used in the same building or branch sites are being used to separate hot from cold. Some practices have collaborated to establish joint hot hubs. The exact number is not easy to state, partly as escalation and de-escalation plans mean that the number of hot hubs has changed over the past 3 months and may continue to do so as more patients are brought in for more routine appointments (which will require more space for cold work).
  2. Yes – this is the definition being used to distinguish the type of patients being seen in hot and cold sites
  3. No
  4. The models described are for all patients that can be seen in the practices. The aim is still to have as few face-to-face appointments as possible. Those shielding may be able to be seen at home, however, as more routine work is needed to be seen, practices are looking at ways to enable those shielding or other vulnerable groups to be seen safely. One example is the running of flu vaccination clinics which will need to be organised in a different way this year.
  5. Not applicable.
  6. Not applicable.
  7. No.
  8. Not applicable.
  9. NHS Kernow will be reviewing with primary care colleagues what has worked well during the pandemic that we may wish to continue. For example video consultations – and what has not worked so well. The review will also consider a medium-term solution for the split of hot and cold work as the number of those needing to be seen in a hot hub may reduce and amount of cold work will increase. This may lead to hot hubs being established for a larger number of practices. At this stage there is no documentation or data to share.

FOI 81190 spend. Date requested 20 June 2020

Request received

  1. How much have you been allocated by the £1.3bn fund to support faster patient discharges from hospital during the COVID-19 pandemic?
  2. How much have you spent of your allocation from the £1.3bn COVID-19 discharge fund?
  3. How much has your local authority contributed towards the £1.3bn COVID-19 discharge fund?
  4. How many care homes did you provide oxygen to as a result of COVID-19 outbreaks between 1 March to 15 April and 15 April to 16 June?
  5. How many COVID-19 outbreaks have there been in care homes in your area from 1 March 2020 to date?

Our response – 14 July 2020

  1. NHS Kernow has not been given a specific allocation out of the £1.3bn funding. The current finance regime requires NHS Kernow to report actual spend in relation to the hospital discharge programme, for reimbursement in due course.
  2. To the end of May 2020, NHS Kernow reported total spend of £4.3m in relation to the hospital discharge programme. This includes both costs incurred directly by the CCG and those incurred by our local authority partners.
  3. NHS Kernow are currently in discussion with our local authority partners over the appropriate level of their baseline costs to take into account when assessing the additional costs of the hospital discharge programme. A final amount has not yet been determined.
  4. Nil. NHS Kernow utilised community beds to provide piped oxygen to individuals where required. Additionally the home oxygen service is not provided to care homes it is provided to specific individuals and therefore the information requested does not exist.
  5. 62 outbreaks have been reported. Of which 27 were laboratory confirmed, 32 were classed as suspected and 3 unknown at time of responding.
Organisation

FOI 81100 primary care networks. Date requested 11 June 2020

  1. In 2019 to 2020, how much maximum funding was the CCG entitled to under NHS England’s additional roles reimbursement scheme?
  2. In 2019 to 2020, did the CCG use all of the funding it was entitled to under NHS England’s additional roles reimbursement scheme? For the original intended purpose of hiring extra clinical pharmacists and social prescribers in primary care networks (PCNs).
  3. If no, how much of that 2019/20 funding was not spent on hiring extra clinical pharmacists and social prescribers in PCNs?
  4. Of the money that was left over (for example the answer to question 3), how much of this was used to recruit any of the 10 roles included in the additional roles reimbursement scheme from 1 April 2020?
  5. Of the money that was left over (for example the answer to question 3), how much of this was used to fund other CCG activities not related to the additional roles reimbursement scheme? Please provide examples.
  6. Of the money that was left over (for example the answer to question 3), how much of this still remains unspent?

Our response – 12 June 2020

  1. £1,078,844.75.
  2. No.
  3. £822,331.57.
  4. £690,331.
  5. None. The remaining funds have been used by PCNs to fund workforce planning and transformation projects.
  6. None.
Prescribing and pharmacies

FOI 81160 Rebate schemes. Date requested 17 June 2020

Request received

For the period 1 January 2020 to 1 June 2020, could you confirm whether you have a primary care rebate scheme in existence for each of the following drugs:

  • Clexane
  • Inhixa
  • Becat
  • Arovi
  • Fragmin
  • Innohep

Please answer yes or no for each product. Once again I am requesting no pricing details simply a yes or no response.

Our response – 23 June 2020

The drugs listed in your question are not included in NHS Kernow’s primary care prescribing rebate schemes.

Details of NHS Kernow’s primary care prescribing rebate schemes are available on our website.

FOI 81290 Parkinsons. Date requested 26 June 2020

Request received

I note from the link provided that virtually no apomorphine is prescribed in your CCG, yet I am aware that these CCGs each have a normal distribution of Parkinson’s patients.

Does your CCGs not permit the prescribing of apomorphine? If not, can you explain the rationale behind this.

I note that hospitals do prescribe Apomorphine. Could you confirm if whether there is a pass through or another method for NHS trusts to pass the costs back to CCGS? If not, since it is a tariff drug and the trusts have no other funding method, are you in fact driving inequity or postcode prescribing by preventing the use of apomorphine?

Our response – 9 July 2020

Apomorphine is on the Cornwall Joint Formulary as a specialist initiated drug for Parkinson’s disease. There are also shared care guidelines for apomorphine link also available through the formulary.

There is no inequity or postcode Apomorphine prescribing. Whilst Apomorphine is specialist initiated it is initially prescribed by the consultant nurse within the community. Medical consultants and Parkinson’s specialist nurses refer patients from across the county, for consideration of this treatment. Once the patient is stable on this treatment, the GP is asked to take over the ongoing prescribing, as per shared care guidance.

Referral management

FOI 81050 Ophthalmology services. Date requested 4 June 2020

Request received

Could you please provide the following information with regarding the commissioning of screening for hydroxychloroquine retinopathy:

  1. Have you specifically commissioned this service in your CCG?
  2. Please provide details of the providers you have commissioned for this service and whether they are a NHS trust or an independent provider.

Our response – 23 June 2020

Yes, Royal Cornwall Hospitals NHS Trust.

FOI 81120 contract. Date requested 12 June 2020

Request received

  1. Does the CCG have a referral management system that operates across your localities? If yes, is it a single system managed by a single provider, or a collaborative partnership between providers? If no, Has the CCG considered a referral management service (RMS) for their system providers to increase efficiency within the local health pathways?
  2. Is any referral management system contracted through competitive tender or delivered through a local provider agreement?
  3. Where contracted, who is the current provider of the RMS, and what clinical specialities are covered (for example ENT, dermatology)?
  4. Is the contract delivered in partnership with other providers? If so, who are the providers and from what sector (for example third sector, contractors)
  5. What is the contract length and contract value of the current RMS contract?
  6. What is the delivery model for the current RMS?
    • Does the service offer an administrative service to direct referrals to the relevant service who then triage them for appropriateness?
    • Does the RMS triage service to ensure referrals are directed to the correct service or returned to the referrer?
    • What services does the service manage referral? For example, community, specialist, secondary care
    • Who does the service accept referrals from? For example GPs, Other healthcare professionals, Self-Referrals.
  7. Would it be possible to get a copy of the current service specification?
  8. When is the current RMS due to be re-tendered?
  9. Is this date before contract extension (if so, what is the extension period and likelihood of extension)?
  10. Is it anticipated the re-tendered service will adhere to the same model and specification as the current RMS?
    • If not, how do you expect this service to differ? Will you be undertaking market engagement ahead of any procurement process to inform this model?
    • If yes, do you anticipate the contract length and financial envelope to remain the same or efficiency savings to be applied? What percentage reduction would this be?
  11. Has the current RMS met all of the contracted KPIs during the lifetime of the contract?
  12. Has the current provider of the RMS been served with any performance notices? If yes, when were they served and what for?
  13. Are there any areas of particular concern within the CCGs population which the RMS could be addressing more effectively?
  14. Are there any areas of exceptional practice and/or innovation in the current RMS which stand out to the CCG?
  15. What is the current patient satisfaction rate for the RMS? Has this remained consistent or has there been fluctuations (reduced or improved)?
  16. Which virtual/remote platforms are used in the current RMS? Telephone, video general (WhatsApp, Skype, Zoom) or video bespoke (Q-Doc, Attend Anywhere)
  17. Has the RMS continued to operate routine appointments during the COVID-19 pandemic via remote methods alongside Emergency/Urgent referrals?

Our response – 6 July 2020

  1. Yes. NHS Kernow has an internal RMS. The RMS covers 50 practices and also has a contract with NHS Devon CCG’s referral support service to cover the remaining practices in east Cornwall.
  2. The RMS is a service internal to NHS Kernow. The DRSS service is delivered through a contract with the bordering CCG.
  3. The RMS is not contracted as it is an internal NHS Kernow function. DRSS is a function within NHS Devon CCG.
  4. No.
  5. Cornwall’s service does not have a contract as it is an internal function of the CCG. DRSS Service contracted between NHS Kernow and NHS Devon CCG, commenced April 2013 and has rolled each year. Total annual contract is a block element of £185,420 and KPI performance related payment of £40,000.
  6. Yes, both the RMS and DRSS. RMS: referrals to secondary care and some community services. DRSS: community, mental health, specialist and secondary care. RMS: GPs (and practice based clinicians), dentists, general healthcare professionals and self-referrals in relation to termination of pregnancy referrals only. DRSS: GPs (and practice based clinicians), general healthcare professionals. For example ESPs, physio’s, opticians, dentists and schools and social workers in relation to mental health services.
  7. The current service specification was attached to the response. Email our FOI team for a copy of the response.
  8. No outsourcing review has taken place and currently remains managed internally by the relevant CCGs.
  9. See response 8.
  10. See response above. Any outsourcing review would involve engagement with relevant stakeholders. No outsourcing review of the service has taken place to answer this question.
  11. Yes where they have been set.
  12. No.
  13. None currently known.
  14. Nothing specific identified.
  15. Unable to answer as information not collected.
  16. Telephone and e-RS.
  17. Yes.

FOI 81230 Rhinoplasty. Date requested 24 July 2020

Request received

  • Number of septoplasty, septorhinoplasty and rhinoplasty procedures performed in the years 2012 to 2019.
  • Number of individual funding requests made for these procedures in the same period.
  • Number of individual funding requests that were rejected for these procedures in the same period.

Our response – 13 July 2020

  1. Septoplasty: 986. Septorhinoplasty: 209. Rhinoplasty: data does not demonstrate any rhinoplasty procedures performed in this timeframe. NHS Kernow does not routinely commission rhinoplasty procedures.
  2. Rhinoplasty: 8. Septorhinoplasty: 1 (although declined as an IFR, the septoplasty part, being functional, to remove obstruction, would be routinely commissioned)
  3. As question 2.

FOI 81320 contract. Date requested 29 June 2020

Request received

Does your CCG have a referral service or management centre? If so, does it provide:

  1. referral UBRN creation
  2. clinical triage
  3. by GP
  4. by AHP
  5. advice and guidance
  6. via eRS
  7. via other method, for example email
  8. local patient phone booking
  9. incoming from patients
  10. outbound with the referral service calling patients
  11. additional services (please give further details)
  12. cost per referral for financial year 2019 to 2020
  13. cost per head for financial year 2019 to 2020

Our response – 17 July 2020

NHS Kernow has a Referral Management Service which covers 50 GP practices. NHS Kernow also has a contract with Devon Referral Support Service (DRSS) which covers the remaining practices in the east locality.

  1. No. GP practices create the UBRN and submit the referral on eRS to the RMS/DRSS.
  2. Clinical triage.
  3. Yes.
  4. No.
  5. Advice and guidance.
  6. Not using the advice and guidance function on eRS, but advice can be given as part of the triage process once a referral is received.
  7. No.
  8. Local patient phone booking.
  9. Yes.
  10. Yes.
  11. Not applicable.
  12. RMS: £5.62 (estimated). DRSS: £4.01 (estimated).
  13. RMS: £1.62 per head of population (estimated). DRSS: £1.08 per head of population (estimated).

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